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A nurse in a community mental health clinic is caring for a group of clients. The nurse should encourage participation in cognitive behavioral family therapy in response to which of the following client statements?
- A. I want to learn how to change the way I react to problems within my family
- B. I want to understand why my past experiences are affecting my family relationships
- C. I want to improve my family’s understanding of each other’s boundaries
- D. I want each of my family members to be more aware of each other’s feelings
Correct Answer: A
Rationale: The correct answer is A because cognitive behavioral family therapy focuses on changing negative thought patterns and behaviors. By wanting to change the way they react to family problems, the client is demonstrating a readiness to engage in cognitive restructuring and behavioral change. Choice B is incorrect as it pertains more to individual therapy exploring past experiences. Choice C is incorrect as it focuses on improving understanding of boundaries, which is not the primary goal of cognitive behavioral family therapy. Choice D is incorrect because it emphasizes awareness of feelings rather than addressing reactive behaviors.
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A nurse is caring for a school-aged child who has conduct disorder and is being physically aggressive toward other children in the unit. Which of the following actions should the nurse take first?
- A. Place the child in seclusion
- B. Use therapeutic hold technique
- C. Apply wrist restraints
- D. Administer risperidone
Correct Answer: A
Rationale: The correct answer is A: Place the child in seclusion. The first step in managing physically aggressive behavior in a child with conduct disorder is to ensure the safety of the child and others. Placing the child in seclusion helps prevent harm to others while allowing the child to calm down in a controlled environment. Using therapeutic hold technique (B) or applying wrist restraints (C) may escalate the situation and increase the risk of harm. Administering risperidone (D) is a medication intervention that should be considered only after addressing the immediate safety concerns.
A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract?
- A. Use projection during group therapy
- B. Increase self-esteem
- C. Use bargaining skills for behavioral consequences
- D. Decrease the number of verbal outbursts
Correct Answer: D
Rationale: The correct answer is D: Decrease the number of verbal outbursts. For a client with antisocial personality disorder, managing impulsivity and aggression is crucial. Decreasing verbal outbursts helps improve social interactions and relationships. Using projection (A) can exacerbate manipulative behavior. Increasing self-esteem (B) may not address the core issues of the disorder. Using bargaining skills (C) might reinforce manipulative tendencies rather than promoting genuine change in behavior.
A nurse in a mental facility is assessing a client for suicide risk factors using the SAD PERSONS scale. Which of the following findings indicates a risk for suicide?
- A. The client is married
- B. The client is female
- C. The client is 50 years of age
- D. The client has diabetes mellitus
Correct Answer: C
Rationale: The correct answer is C: The client is 50 years of age. The SAD PERSONS scale includes age as a risk factor for suicide. As individuals get older, they may face more challenges such as chronic health conditions, loss of loved ones, or financial difficulties, which can increase suicidal ideation. This age group is considered at higher risk for suicide compared to younger individuals. Choices A, B, and D do not directly relate to suicide risk factors according to the scale. Being married (A) can sometimes be a protective factor, being female (B) is not a specific risk factor, and having diabetes mellitus (D) is a medical condition that is not directly associated with suicide risk based on the scale.
A nurse in a community clinic is planning an educational session for a group of clients. Which of the following strategies should the nurse use when teaching about stress management?
- A. Provide lengthy lectures on stress
- B. Encourage discussion and practice of coping skills
- C. Discourage clients from expressing emotions
- D. Teach all clients the same stress-reduction technique
Correct Answer: B
Rationale: The correct answer is B: Encourage discussion and practice of coping skills. This strategy is effective because it actively engages clients in learning and applying coping mechanisms, promoting better retention and skill development. By encouraging discussion, clients can share experiences and support each other, enhancing their understanding and motivation. Practicing coping skills helps clients to internalize and apply them in real-life situations.
Incorrect choices:
A: Providing lengthy lectures is less effective as it can be overwhelming and may not actively involve clients in learning.
C: Discouraging clients from expressing emotions hinders the therapeutic process and can lead to bottling up emotions, increasing stress.
D: Teaching all clients the same technique may not address individual needs and preferences, limiting the effectiveness of stress management strategies.
A nurse is assessing a client who is withdrawing from heroin. Which of the following manifestations should the nurse expect?
- A. Slurred speech
- B. Hypotension
- C. Bradycardia
- D. Hyperthermia
Correct Answer: D
Rationale: The correct answer is D: Hyperthermia. Heroin withdrawal can lead to hyperthermia due to increased metabolic activity, dehydration, and dysregulation of the body's temperature control mechanisms. Slurred speech (A) is not a typical manifestation of heroin withdrawal. Hypotension (B) and bradycardia (C) are more commonly associated with opioid overdose rather than withdrawal. In withdrawal, the client may actually experience hypertension and tachycardia due to increased sympathetic activity.